Objective To observe the effec t and safety of posaconzole in prophylactic antifungal treatment of high-risk patients with hematological malignancies. Methods The effect of posaconzole on prevention of invasive fungal disease (IFD) during chemotherapy in 102 patients with hematological malignancies in Shanghai Ruijin Hospital from February 2014 to April 2017 were analyzed retrospectively. The correlation analysis was carried out by Spearman analysis. Results A total of 102 patients were included, and only 2 (1.96%) patients had IFD. 2 patients died because of development of hematological malignancies. 11 (10.8%) patients had to discontinuation of posaconzole because of sever adverse events. Two patients with IFD and 1 case of undiagnosed IFD had to discontinue posaconzole. The total rate of discontinuation was 13.7 % (14/102). There was no correlation between the time of using pothiazol and the time of hospitalization (rs= -0.02, P= 0.853) and the time of neutrophilic deficiency (rs= 0.167, P= 0.113), but the time of hospitalization was positively correlated with the time of neutrophilic deficiency (rs = 0.448, P=0.000). Conclusion Posaconzole could effectively and safely prevent IFD in patients with hematological malignancies.

Objective To observe the clinical efficacy and safety of the lenalidomide-based therapy regimen in the treatment of high-intermediate-risk B-cell non-Hodgkin lymphoma (B-NHL). Methods A retrospective analysis of 23 high-intermediate-risk B-NHL patients who were admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2015 to February 2018 was conducted, of which 7 relapsed or refractory (R/R) patients received lenalidomide combined with rituximab (R2) and plus different salvage chemotherapy regimens (DHAP, GDP, ICE) of each 28-day cycle; 5 elderly patients were initially treated with R2 of each 28-day cycle; 11 patients were administered by maintenance monotherapy of lenalidomide of each 28-day cycle, or R2 therapy of 3-month cycle. The primary endpoint was overall response, and the secondary endpoints were progression-free survival (PFS) and safety. Results The median follow-up time was 4.5 months (1-20 months) in the R/R and elderly initial-treated patients. The median time to response in the R/R group was 3 months (2-7 months), of which 3 patients were complete remission (CR), overall response was 3 patients, and the median PFS was 7 months. The median time to response in the elderly initial treatment group was 4 months (2-5 months), 1 of 4 eligible patients was CR and 2 were partial remission (PR), overall response was 3 patients, and the median PFS time had not reached. The median follow-up time in the maintenance treatment group was 15 months (2-32 months), the median PFS time had not reached, and the 1-year PFS rate was 64％ (95％ CI 36％-92％). The most common grade 3-4 adverse events were leukopenia and thrombocytopenia, each accounting for 35％, and most patients were tolerable. Conclusion Lenalidomide as an immunomodulator is effective and safety for elderly initial treatment, R/R and maintenance treatment patients with high-intermediate-risk B-NHL, and it can prolong their survival.

ObjectiveTo compare and observe the effect of Reduning injection （mainly clearing heat）， Shenfu injection （mainly warming Yang） combined with gefitinib on the proliferation， apoptosis， stemness characteristics and metabolism of lung cancer cells. MethodDifferent non-small cell lung cancer （NSCLC） cell lines were selected and intervened with gefitinib （5， 10， 20 μmol·L^-1）， Reduning injection （0.6%， 0.9%）， Shenfu injection （0.6%， 0.9%）， gefitinib combined with Reduning injection， and gefitinib combined with Shenfu injection. Cell proliferation in each group was detected by cell counting kit-8 （CCK-8） assay， and cell apoptosis was detected by flow cytometry. The mRNA and protein expressions of lung cancer stem cell markers sex determining region Y-box 2 （Sox2） and aldehyde dehydrogenase family 1 member A1 （ALDH1A1） were determind by real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. The redox ratio of lung cancer cells was observed by femtosecond label-free imaging （FLI） and energy metabolism instrument was used to determine the glycolysis level in cells. ResultCompared with the blank group， Reduning injection reduced the survival rate of lung cancer cells （P<0.05）， increased the apoptosis rate （P<0.05）， down-regulated the mRNA and protein expressions of Sox2 and ALDH1A1 （P<0.05）， and up-regulated the redox ratio of cells （P<0.05）， while Shenfu injection exerted no remarkable effect on the above indexes. In addition， compared with gefitinib alone， Reduning injection combined with gefitinib inhibited the survival rate of lung cancer cells （P<0.05）， promoted the cell apoptosis （P<0.05）， down-regulated the mRNA and protein expressions of Sox2 and ALDH1A1 （P<0.05）， up-regulated the redox ratio of cells （P<0.05）， and lowered the proton efflux rate of glycolysis （P<0.05）， while Shenfu injection combined with gefitinib failed to affect these indexes of lung cancer cells significantly. ConclusionReduning injection may inhibit stemness characteristics of tumor cells by regulating their metabolism to enhance the proliferation-inhibiting and pro-apoptotic effects of gefitinib on lung cancer cells， while Shenfu injection had no significant enhancing effect on gefitinib. This indicates that epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKIs） should be used in combination with heat-clearing Chinese medicines.